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A comprehensive prognostic stratification for patients with metastatic renal clear cell carcinoma

Title
A comprehensive prognostic stratification for patients with metastatic renal clear cell carcinoma
Authors
Cho K.S.Choi Y.D.Kim S.J.Kim C.I.Chung B.H.Seong D.H.Lee D.H.Cho J.S.Cho I.R.Hong S.J.
Ewha Authors
이동현
SCOPUS Author ID
이동현scopus
Issue Date
2008
Journal Title
Yonsei Medical Journal
ISSN
0513-5796JCR Link
Citation
vol. 49, no. 3, pp. 451 - 458
Indexed
SCI; SCIE; SCOPUS; KCI WOS scopus
Abstract
Purpose: To develop a reliable prognostic model for patients with metastatic renal cell carcinoma (RCC) based on features readily available in common clinical settings. Patients and Methods: A total of 197 patients with RCC who underwent nephrectomy and immunotherapy from 1995 to 2004 were retrospectively reviewed. Their mean age was 55.1 ± 11.8 yrs (24-83 yrs) and mean survival time from metastasis was 22.6 ± 20.2 mos (3-120 mos). The impact of 24 clinicopathological features on disease specific survival was investigated. Results: On univariate analysis, constitutional symptoms, sarcomatoid differentiation, tumor necrosis, multiple primary lesions, liver metastasis, Eastern Cooperative Oncology Group Performance Status (ECOG-PS), thrombocytosis, alkaline pbosphatase, hematocrit, T stage, N stage, and nuclear grade had significant influence on survival (p < 0.05). Multivariate analysis revealed the following features associated with survival: sarcomatoid differentiation [hazard ratio (HR)=2.99, p<0.001], liver metastasis (HR = 2.09, p = 0.002), ECOG-PS (HR = 1.95, p = 0.005), N stage (HR = 1.94, p = 0.002), and number of metastatic sites (HR = 1.76, p = 0.003). An individual prognostic score was defined as the sum of the weight of these features. According to prognostic scores, patients could be subdivided into 3 groups: low risk (score 0), intermediate risk (score 1 or 2), and high risk (score ≥ 3). Conclusion: A comprehensive prognostic stratification model was developed to predict survival and stratify patients for prospective clinical trials.
DOI
10.3349/ymj.2008.49.3.451
Appears in Collections:
의과대학 > 의학과 > Journal papers
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